Portacaval Shunt

What is a Portacaval Shunt?

A portacaval shunt is a major surgical procedure that is used to create a new connection between blood vessels in your liver. Your doctor will recommend this procedure if you are suffering from severe liver problems.

What the Treatment Addresses

When you’re healthy, blood from your stomach, intestines, and esophagus flows through the liver. The portal vein (or “hepatic portal vein”) carries blood from the digestive system to the liver.

However, if your liver is severely damaged, the blood will not flow through it at a healthy rate. This causes the blood to back up, increasing pressure at the portal vein. This causes a condition known as portal hypertension. There are a number of potential underlying causes of portal hypertension, including:

blood clots

alcohol abuse

too much iron in the liver

viral hepatitis

In turn, portal hypertension can lead to more serious health issues, including:

bleeding from the veins in the esophagus, stomach, or intestines

fluid buildup in the stomach

fluid buildup in the chest

Budd-Chiari syndrome (clots in the vein that transports blood from the liver to the heart)

The Portacaval Shunt Procedure

You will be given general anesthetic so that you are asleep and do not feel any discomfort during this surgical procedure. Your surgeon will make a large incision in your abdomen, and will connect the portal vein (the short vein that supplies the liver with blood) to the inferior vena cava (the blood vessel that takes blood from the organs and lower limbs to the heart). By making this new connection, blood will bypass the liver and reduce the blood pressure in the liver.

Benefits of the Treatment

Potential Risks of the Procedure

Anesthetics Risks

Though most healthy people do not have any problems with general anesthesia, there is a small risk of complications and, though rarely, death. These risks are largely dependent upon your general health and the type of procedure you are undergoing. Some factors may increase your risk of complications, such as:

medical conditions involving your lungs, kidneys, or heart

family history of adverse reactions to anesthesia

sleep apnea

obesity

allergies to food or medications

alcohol use

smoking

If you have such medical complications or are elderly you may be more at risk of the following complications, though these are rare:

heart attack

lung infection

stroke

temporary mental confusion

death

Anesthesia Awareness

Anesthesia awareness is the unintended awakening or awareness of a patient during general anesthesia. This may happen if you have not been given enough general anesthesia. It is very rare, though—according to the Mayo Clinic, it only happens in one or two people out of every 1,000 (Mayo Clinic, 2010). Should this happen, you will wake very briefly and may be aware of your surroundings but will feel no discomfort.

On extremely rare occasions some people will experience severe pain, which can lead to chronic emotional and psychological problems. Factors that may increase the risk of anesthesia awareness include: